The Internet may be guilty of many things, but unlike Viagra you cannot yet purchase euthanasia online! An online encyclopaedia defines euthanasia as 'either painlessly putting to death or failing to prevent death from natural causes in cases of terminal illness or irreversible coma'. Most of the debate surrounds active euthanasia, although practices such as withdrawing nutrition might be considered in either category.
Probably the most helpful Internet resource is www.euthanasia.com, full of links to articles from all over the Internet. The site is pro-life and includes such gems as the position of the American Medical Association, and an article suggesting that most euthanasia requests will disappear with antidepressant treatment.
The BBC News site special report proved informative. The introduction cites the important 1992 Dr Cox case where a rheumatologist was found guilty of attempted murder by injecting potassium chloride. He was given a suspended sentence and continues to practise. Coverage of the recent Moor case succeeds in making the vital distinction between death as an unintended result of a painkilling injection and an intentional killing such as occurred in the Cox case. In many ways the Moor case simply confirms this principle of double effect -a doctor is ethical if s/he runs the known risk of a fatal outcome of a treatment, provided the intended outcome of that treatment was, eg, to relieve pain. This principle and its limitations are discussed in recent BMJ editorials.
Rather amusingly, on at least one of their pages, the BBC's link to the Voluntary Euthanasia Society sends you instead to the Virginia Episcopal School! Adding the suffix 'UK' to the address takes you to the correct site, where amongst other interesting points is their view that in fact many doctors do intend to kill when pre-scribing painkillers to terminally ill patients. They argue 'this is a hypocritical way for doctors to avoid accepting responsibility for the consequences of their action. In no other area of law is a good intention the only means of avoiding prosecution.'
It might be argued doctors should have to show they used sufficient discretion in the prescription, including perhaps considering using opiate antagonists where clear signs of opiate poisoning occur. Any doctor has seen, however, that the progress of a patient placed on an opiate drip is by no means certain. Doctors who wilfully prescribe massive doses without first trying smaller doses to control pain might legitimately be charged with such hypocrisy.
Unfortunately the BBC page entitled Euthanasia and the law was neither complete nor accurate. It states only a few cases have occurred in the UK in recent years. A false statement that Anthony Bland had a life-support machine switched off, when in fact he was deprived of nutrition (which the BBC itself states elsewhere) was removed when Cyberdoc complained to the editor by e-mail. It is good the BBC was so responsive and shows how the Internet allows easy influence over such a prestigious information provider.
Unfortunately many significant cases are still not described and the CMF's Euthanasia Update provides a much better summary of legal cases in the UK. Reading this, a disturbing picture of the UK situation emerges. Cases many would see as serious including depriving an elderly lady of food and drink are withdrawn from prosecution. On the few occasions a conviction occurs, the sentences passed seem grossly inadequate. It would appear from this reading that the UK is moving towards a position where euthanasia is unofficially tolerated. Conspiracy theorists among us might be forgiven for thinking that Moor was allowed to come to trial precisely because it was so clear he would be found not guilty. One wonders how long it will be before a de facto legalisation of euthanasia occurs? - law that is not enforced is surely no longer law. This is the way other countries have gone.
The CMF pages also explore the biblical view on euthanasia, and include copies of submissions to governments, together with an article which strongly links euthanasia and abortion. The BBC provides an update on Dr Jack Kevorkian, an American promoter of euthanasia, who was thought unlikely ever to stand trial again. This April he was sent to prison having been convicted of murder. Somehow the portrayal of this ex-doctor as a hero by some, seen in a BMJ editorial (BMJ 1996;312:1434 (8 June)) and the website from his ex-lawyer, Geoff Fieger negates any sense of satisfaction this news might bring to pro-life professionals. A site from the Detroit Free Press presents a comprehensive overview of Kevorkian's clients, and the aftermath of assisted suicide.
The connection with abortion is interesting, with the medical establishment currently at least generally in favour of the pro-life position on euthanasia but not of course on abortion. Now that 30 years have passed since abortion became acceptable, one wonders whether euthanasia of the elderly may shortly be firmly on the agenda, as one of the BBC pages seems to imply. Perhaps the generation that began killing its children will indeed be killed by its children.
